Abstract

Up till now, the health of children conceived by ART has been
described from infancy up to pubertal age, but not beyond. Also, adverse cardiometabolic
and vascular outcomes have been described in both IVF and ICSI
offspring, but the impact of ART on the reproductive health of the offspring
remained unknown. Whether ICSI- conceived men born to fathers with
impaired spermatogenesis are at risk of inheriting deficient spermatogenesis
from their fathers, could not be answered due to their young age. Since the oldest
ICSI offspring cohort worldwide has recently reached adulthood, their
reproductive health can now be investigated. Moreover, since these children
were conceived by ICSI because of severe male-factor infertility, there is reasonable
concern that male offspring have inherited the deficient spermatogenesis
from their fathers. Previously normal pubertal development and adequate
Sertoli and Leydig cell function has been described in pubertal ICSI boys, however,
no information on their sperm quality is currently available. Therefore, we
investigated the semen quality of young adult men that were conceived 18-22
years ago by ICSI for male infertility.
Material and Methods: The present study was conducted at UZ Brussel
between March 2013 and April 2016 and is part of a large follow-up project
focussing on reproductive and metabolic health of young adults, between 18
and 22 years and conceived after ICSI with ejaculated sperm. Results of both a
physical examination and semen analysis were compared between young ICSI
men being part of a longitudinally followed cohort and spontaneously conceived
controls who were recruited cross-sectionally.
Results of a single semen sample in 54 young adult ICSI men and 57 spontaneously
conceived males are reported. All young adults were individually
assessed and the results of their physical examination were completed by questionnaires.
Data were analysed by multiple linear and logistic regression,
adjusted for covariates. In addition, semen parameters of the ICSI fathers dating
back from their ICSI treatment application were analysed for correlations.
Results: Young ICSI adults had a lower median sperm concentration (17.7 million/
ml), lower median total sperm count (31.9 million) and lower median total
motile sperm count (12.7 million) in comparison to spontaneously conceived
peers (37.0 million/ml; 86.8 million; 38.6 million). The median percentage progressive
and total motility, median percentage normal morphology and median
semen volume were not significantly different between these groups. After
adjustment for confounders (age, BMI, genital malformations, time from ejaculation
to analysis, abstinence period), the statistically significant differences
between ICSI men and spontaneously conceived peers remained: an almost
doubled sperm concentration in spontaneously conceived peers in comparison
to ICSI men (ratio 1.9, 95% CI 1.1-3.2) and a two-fold lower total sperm count
(ratio 2.3, 95% CI 1.3-4.1) and total motile count (ratio 2.1, 95% CI 1.2-3.6) in
ICSI men compared to controls were found. Furthermore, compared to males
born after spontaneous conception, ICSI men were nearly three times more
likely to have sperm concentrations below the WHO reference value of 15 million/
ml (AOR 2.7; 95% CI 1.1–6.7) and four times more likely to have total
sperm counts below 39 million (AOR 4.3; 95% CI 1.7-11.3). In this small group
of 54 father-son pairs, a weak negative correlation between total sperm count
in fathers and their sons was found.
Conclusion: Although these first results in a small group indicate a lower
semen quantity and quality in young adults born after ICSI for male infertility in
their fathers, results cannot be generalised to all ICSI offspring because the indications
for ICSI have nowadays been extended and ICSI is also being performed
with non-ejaculated sperm and reported differences may thus either decrease
or increase.
Original languageEnglish
Pages (from-to)i508-i508
Number of pages1
JournalHuman Reproduction
Volume33
Issue numberSuppl
Publication statusPublished - 2018
EventESHRE 2018 - CCIB, Barcelona, Spain
Duration: 2 Jul 20184 Jul 2018

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